American College of Radiology issues guidance related to unusual new CPT code
The American College of Radiology issued new guidance on Wednesday to assist providers who bill for Current Procedural Terminology code 76145.
ACR’s Economics Committee on Medical Physics developed the resource, which covers scenarios where medical physicists evaluate radiation exposure to see if it exceeds institutional review thresholds.
The Centers for Medicare & Medicaid Services now reimburses for this code—allowing physicists to contribute monetary value to the care team for their work.
“The guide is intended to provide suggestions for practical clinical implementation of this code and offers key considerations, CMS current payment rates, and resources to assist ACR members,” the college said in a March 13 news update. “For those who have yet to implement this code, discuss it with your department manager/administrator.”
ACR’s new guidance is geared toward medical and imaging physicists, interventional and cardiovascular radiologists, billing managers and coding staff. The code was primarily developed with fluoroscopic peak skin dose estimates in mind, but it also could be used for other organ-specific dose evaluation, the college advised.
“This is the first CPT code explicitly recognizing the efforts of imaging medical physicists and allows hospitals to bill for their services directly,” ACR said in the two-page document. “The creation and implementation of CPT code 76145 resulted from a nearly decade-long cooperative effort of the American Association of Physicists in Medicine, American College of Radiology, Society of Interventional Radiology and American College of Cardiology. The code captures the considerable work required to complete a careful, patient-specific dose evaluation for patients who have undergone one or more high-dose procedures and are at increased risk of a severe deterministic radiation effect.”
CMS will pay approximately $890.64 for this service, a total calculated by multiplying the code’s RVU by the 2024 conversion factor. However, payment will vary depending on the geography, ranging as high as $1,253.72. ACR urged providers to carefully consider the physicist’s activities, use of equipment and time spent in the procedure room when billing for the service.
“To those who have already implemented this code, thank you!” the document concluded. “This procedure demonstrates the value of imaging physics and is an important step in improving patient care.”
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.